Youth suicide is a national and global public health crisis. Pediatricians can use primary and secondary prevention strategies to intervene with youth before or after the onset of suicidal behaviors. Universal suicide risk screening programs can be used to identify youth in medical settings who may otherwise pass through the health care setting with undetected suicide risk. Pediatricians are uniquely positioned to help foster resilience in their young patients and equip families of at-risk youth with safety plans and lethal means safety counseling. Pediatricians on the frontlines of this critical public health crisis require education and training in detecting suicide risk, managing those who screen positive, and connecting their patients to much needed mental health interventions and treatments. Evidence-based suicide risk screening and assessment tools, paired with interventions, are feasible and potentially life-saving in the medical setting.

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Nasal continuous positive airway pressure (NCPAP) has been the initial respiratory support for many preterm infants with respiratory distress syndrome (RDS). Nasal intermittent positive-pressure ventilation (NIPPV) seems to increase the beneficial effects of NCPAP by combining it with ventilatory inflations.

This study suggests that NIPPV, as an intial respiratory support for preterm infants with RDS, is feasible and safe and may have beneficial effects, when compared with NCPAP. (Read the full article)

Preventive asthma medications (PAMs) are a primary management strategy to control asthma morbidity. Little is known about changes over time in prevalence of PAM use among children and adolescents in the United States.

Our analysis demonstrates an increase in use of PAMs among children and adolescents with current asthma in the United States from 1988–1994 to 2005–2008, but racial and ethnic disparities in use of PAMs persist. (Read the full article)

Prematurely born children have an increased prevalence of behavioral problems in the long term. Knowledge regarding the effects of early intervention programs is sparse, and more randomized controlled trials are warranted.

A modified version of the Mother-Infant Transaction Program showed beneficial effects on behavioral outcomes reported by both parents of preterm infants with birth weights of <2000 g at a corrected age of 5 years. (Read the full article)

Lactoferrin is a glycoprotein with anti-infective activities being part of the innate defensive network. Bovine and human lactoferrin share high homology. Bovine lactoferrin can prevent late-onset sepsis in preterm very low birth weight neonates.

In preterm very low birth weight infants, bovine lactoferrin is able to prevent not only late-onset sepsis but also systemic fungal infections. This protection is achieved independently from their colonization status. (Read the full article)

There are a number of effective interventions designed to prevent childhood/adolescent depression. Such interventions tend to comprise screening and the subsequent provision of psychological therapy. However, the cost-effectiveness of routinely providing such interventions at a population level is not known.

By using economic modeling techniques, this study shows that the population cost-effectiveness of such preventive interventions for childhood/adolescent depression is very favorable, although implementation issues, particularly around the acceptability to providers, need to be addressed before widespread adoption. (Read the full article)

Children undergoing stem cell transplantation are thought to be at risk for increased distress, adjustment difficulties, and impaired health-related quality of life. Few interventions to improve adjustment and quality-of-life outcomes in this setting have been tested.

The excellent outcomes observed in all patient groups, including controls, may be a result of improvements in standard supportive care. Stem cell transplantation may not be as demanding as previously thought to be, and children undergoing this procedure appear resilient to the challenge. (Read the full article)

The evidence base for obesity prevention is extremely limited. Although minority youth are at higher risk of obesity, and early childhood is a critical period for prevention, only 1 program has demonstrated sustained effects on obesity in young minority children.

Among youth at high risk for obesity based on income, minority status, and child behavior problems, early intervention that promotes effective parenting led to meaningful differences in obesity in preadolescence. Early family intervention is an innovative and promising approach. (Read the full article)

Clinic-based weight control treatments for youth have largely been designed for preadolescent children and their families by using family-based care, a strategy that may be less appealing to adolescents as they become increasingly motivated by peer acceptance rather than parental influence.

To our knowledge, this is the first study to demonstrate the efficacy of a primary care–based, multicomponent lifestyle intervention specifically tailored for overweight adolescent females and demonstrating a sustained effect (at 12 months) extending beyond the active 5-month intervention. (Read the full article)

Strategies to assist patients in achieving optimal chronic disease self-management are critical. The complex family and regimen issues surrounding pediatric type 1 diabetes management suggest the need to integrate such strategies into routine clinical care.

This study demonstrates the efficacy of a practical, low-intensity behavioral intervention delivered during routine care for improving glycemic outcomes. Findings indicate that the approach may offer a potential model for integrating medical and behavioral sciences to improve health care. (Read the full article)

Infants born to women who are hepatitis B surface antigen–positive have a 90% risk of chronic hepatitis B virus infection, which may cause premature death from liver failure or cancer. Postexposure prophylaxis in infancy prevents 85% to 95% of perinatal infections.

The Perinatal Hepatitis B Prevention Program was created to identify and manage infants born to women who are hepatitis B surface antigen–positive. We provide, for the first time since 1996, national-level data on the outcomes of the Perinatal Hepatitis B Prevention Program. (Read the full article)

Pain during routine infant immunization causes parental anxiety. Oral sucrose solutions are effective pain-reduction strategies. Few studies have measured a combined strategy of a physical intervention along with sucrose to decrease the infant’s pain response.

We demonstrate that a physical, nonpharmacological intervention called the 5 S’s (swaddling, side/stomach position, shushing, swinging, and sucking) provides significant pain reduction with or without sucrose during routine 2- and 4-month vaccinations. (Read the full article)

Youth violence and alcohol misuse are a preventable public health problem. Previous studies have demonstrated the efficacy of brief interventions in the emergency department (ED) in reducing alcohol misuse and related consequences among older adolescents and adults.

This study supports the efficacy of brief interventions in the ED in reducing peer aggression and victimization 12 months after ED visit. The previous reductions in alcohol consequences noted at 6 months follow-up were not sustained at 12 months. (Read the full article)

Neonatal follow-up programs are designed in part to identify developmental delays among high-risk infants after NICU hospitalization and make referrals to state-funded early intervention. Early intervention has been shown to benefit children with developmental delays.

Many high-risk infants demonstrating developmental delays at neonatal follow-up programs are not referred to early intervention. Subspecialty clinics share responsibility with the medical home in referring children from birth through three years with developmental problems to early intervention services. (Read the full article)

Male circumcision reduces risk of HIV acquisition in men by 60% and is associated with other health benefits. Compared with adult circumcision, infant male circumcision is safer, less expensive, and represents a cost-saving intervention for HIV prevention in many settings.

IMC is little known in East Africa and is not routinely practiced. This is the first study to assess acceptability and uptake of IMC in East Africa among parents who were actually offered the procedure. (Read the full article)

Comprehensive lifestyle interventions for adolescent weight management, including diet, physical activity, and behavioral intervention, have been found to demonstrate modest, short-term success. However, very little is known about the long-term effectiveness of adolescent behavioral weight management trials.

This randomized controlled trial demonstrates that two 16-week group-based behavioral weight loss programs, when combined with either aerobic exercise or peer-based adventure therapy, produced sustained improvements in BMI among overweight/obese adolescents through 24 months. (Read the full article)

Sudden infant death syndrome remains the major cause of postneonatal death in developed countries. Although infant-parent bed-sharing following antenatal smoking or maternal consumption of alcohol on the bed-sharing night increases the risk of death, the mechanism is not known.

Bed-sharing infants experienced more oxygen desaturations and episodes of carbon dioxide rebreathing than cot-sleeping infants but showed appropriate behavioral and physiologic responses. A deficit in these responses in vulnerable infants could link to increased risk of sudden infant death syndrome. (Read the full article)

Childhood obesity is already prevalent by preschool age, particularly among Latinos. Parents have tremendous influence on factors that contribute to childhood obesity (eg, diet, physical activity); thus, family plays a crucial role in pediatric obesity prevention.

This randomized controlled trial examined the effect of a behavioral intervention involving Latino-American parent–preschool-aged child dyads. The intervention resulted in reductions in absolute BMI across the 3-month study period, with patterns suggesting the largest effect for obese children. (Read the full article)

Although observational studies have consistently reported an association between media use and child sleep problems, it is unclear whether the relationship is causal or if an intervention targeting healthy media use can improve sleep in preschool-aged children.

This study demonstrates that a healthy media use intervention can improve child sleep outcomes and adds evidence that the relationship between media and sleep in preschool-aged children is indeed causal in nature. (Read the full article)

Bronchiolitis is one of the most common infectious respiratory conditions of early childhood, and most children have a mild clinical course. Unfortunately, the small subgroup of children requiring continuous positive airway pressure and/or intubation remains ill-defined.

In children with bronchiolitis, we found several demographic, historical, and clinical factors that predicted the need for mechanical respiratory support including in utero smoke exposure. We also found a novel subgroup of children with bronchiolitis who have a rapid respiratory decline. (Read the full article)

Immunization recall systems have been found effective in increasing immunization rates in younger children and adults; however, there have been only a few studies in adolescents and they have produced mixed results.

In this randomized controlled trial, immunization rates were significantly higher 4 weeks after a recall intervention in which both the adolescent’s parents and the adolescent were contacted, but this effect did not persist 1 year after the intervention. (Read the full article)

Childhood obesity is a public health concern. Although determinants of childhood overweight have been identified and their effect sizes have been calculated, prevention as well as treatment have had limited success.

We have calculated the population-based relevance of determinants of childhood overweight by using attributable risks, which can be interpreted as maximum success rates of preventive measures. New concepts were applied to estimate the relative contribution of each risk factor. (Read the full article)

Declining dietary omega 3 polyunsaturated fatty acids has been associated with rising allergy prevalence and fish oil is therefore of interest in allergy prevention. Supplementation during pregnancy, but not after the age of 6 months, has achieved some allergy reductions.

We assessed the effect of fish oil supplementation from birth to 6 months, which has not been investigated previously. Our results, together with previous findings, will likely help define a "window of opportunity" for allergy intervention using fish oil supplements. (Read the full article)

Behavioral techniques effectively reduce infant sleep problems and associated maternal depression in the short- to medium-term (4–16 months’ postintervention). Despite their effectiveness, theoretical concerns persist about long-term harm on children’s emotional development, stress regulation, mental health, and the child-parent relationship.

Behavioral sleep techniques did not cause long-lasting harms or benefits to child, child-parent, or maternal outcomes. Parents and health professionals can feel comfortable about using these techniques to reduce the population burden of infant sleep problems and maternal depression. (Read the full article)

The Global Trigger Tool uses a sampling methodology to identify and measure harm rates. It has been shown to effectively detect adverse events when applied in the adult environment, but it has never been evaluated in a pediatric setting.

The Global Trigger Tool can be used in the pediatric inpatient environment to measure adverse safety events. We detected a 2 to 3 times higher harm rate than previously found with different metrics in this setting. (Read the full article)

Invasive Cronobacter infection is a rare but devastating disease known to affect hospitalized premature or immunocompromised infants fed powdered infant formulas (PIFs). PIF labels imply that powdered formulas are safe for healthy, term infants if the label instructions are followed.

Cronobacter can also infect healthy, term infants in the first months of life, even if PIF label instructions are followed. Invasive Cronobacter infection is extremely rare in exclusively breastfed infants or those fed commercially sterile, ready-to-feed formulas. (Read the full article)

School-Wide Positive Behavioral Interventions and Supports (SWPBIS) is a widely used universal prevention strategy currently implemented in >16 000 schools across the United States. Previous research has shown positive effects on school climate and school-level discipline problems.

This study reports multilevel results on data from a 4-year randomized controlled effectiveness trial of SWPBIS in 37 elementary schools. Results indicate significant impacts on children’s aggressive behavior problems, concentration problems, office discipline referrals, emotion regulation, and prosocial behavior. (Read the full article)

Several meta-analyses evaluating probiotics in preterm infants suggest a beneficial effect for the prevention of necrotizing enterocolitis and death, but less for nosocomial infection. Lactobacillus reuteri may reduce these outcomes because of its immunomodulation and bactericidal properties.

Although L reuteri did not appear to decrease the rate of death or nosocomial infection, the trends suggest a protective role consistent with the literature. Feeding intolerance and duration of hospitalization were significantly decreased in premature infants ≤1500 g. (Read the full article)

Randomized controlled trials of early developmental interventions for very preterm infants demonstrate short-term benefits for infant neurobehavioral functioning. The longer-term benefits of these interventions for children and their families are not yet clear.

This randomized trial shows that home-based preventive care over the first year of life for very preterm infants has selective long-term benefits. Caregivers report less anxiety and fewer were at risk for an anxiety disorder. Preschoolers show fewer internalizing behaviors. (Read the full article)

Drowning is a leading cause of death for children in low- and middle-income countries. However, few childhood mortality reduction programs target drowning because of a lack of evidence on costs and effectiveness of these interventions.

This study presents the cost-effectiveness results of a low-cost injury and drowning prevention program in Bangladesh. We show that child care centers and swimming lessons are highly cost-effective interventions that could be scaled to other countries. (Read the full article)

With increasing survival rates, there is growing interest in long-term quality of life among patients with univentricular heart defects, and neurodevelopmental deficits play a major role in adverse outcome.

Although median cognitive performance was within normal limits, major neurodevelopmental impairment was found in one-fourth, and minor neurologic dysfunction in almost half of patients. Brain MRI showed mostly ischemic findings of different degrees in the majority of patients. (Read the full article)

There is widespread belief that many hospital readmissions in adults are avoidable by improvements in care and discharge planning processes, resulting in significant cost savings; however, current studies have not examined the preventability of such readmissions in children’s hospitals.

The overall rate of pediatric 15-day readmissions considered to be preventable was low, less than 2% of total hospital admissions. Pediatric readmissions are unlikely to serve as a highly productive focus for cost savings or quality measurement. (Read the full article)

Part C early intervention serves ~2.8% of US children who are younger than 3 years old; however, there is evidence that substantial numbers of infants and toddlers with developmental delays receive no early intervention services.

Broad eligibility criteria can classify children who have no delays or minimal delays as candidates for Part C services. Despite this, no jurisdiction provides Part C services to all children who have substantial delays. (Read the full article)

A number of studies have demonstrated community acceptance of Safe Routes to School interventions as well as their success in addressing perceptions about safety, but little is known about their effectiveness in reducing pedestrian injury risk in school-aged children.

Implementation of a Safe Routes to School program in New York City may have contributed to a substantial reduction in school-aged pedestrian injury rates, with the effects largely limited to school-travel hours in census tracts with these interventions. (Read the full article)

While obesity-promoting eating, sedentary and physical activity behaviors, and increased prevalence of adiposity are evident from early life, few high-quality studies have evaluated interventions that seek to influence the development of these behaviors in very early childhood.

This study highlights the receptivity of first-time parents to interventions focused on their new infant’s eating and active play and provides evidence of effectiveness on some obesity-promoting behaviors in very early childhood. (Read the full article)

Children with chronic illnesses are at risk for emotional and behavioral problems. Therefore, interventions that focus on coping with the negative consequences of the disease are needed. Evidence-based interventions are limited and often focus on a single diagnosis group.

This study demonstrates the efficacy of a cognitive-behavioral group intervention for children with various chronic illnesses. The findings indicate that the involvement of parents is important to achieve long-term results. (Read the full article)

Advances in the treatment of critically ill infants have increased survival of extremely low/very low birth weight and medically complex infants. Improved survival can result in prolonged mechanical ventilation and sometimes tracheostomy. Current tracheostomy rates for these infants are unknown.

This long-term review of infants discharged from a NICU with tracheostomies is the first to describe tracheostomy rates specifically in extremely low/very low birth weight infants. It focuses on long-term clinical outcomes and comorbidities rather than surgical complications. (Read the full article)

Early preventive pediatric dental visits are widely recommended. However, the effectiveness of pediatric preventive dental visits in reducing the need for subsequent, more expensive oral health treatment has not been well established.

Using an econometric method that accounts for time-invariant differences between children, and thus helps mitigate selection bias, we found a positive impact of preventive dental visits on oral health. However, there is less evidence regarding the cost-effectiveness of preventive visits. (Read the full article)